临床肝胆病杂志2012，Vol.28Issue(5)：343-348,6.
自身免疫性肝炎和原发性胆汁性肝硬化重叠综合征的临床特征及疗效观察
Observation of clinical feature and curative efficacy on autoimmune hepatitis - primary biliary cirrhosis overlap syndrome
楚金东 1朱疆依 1高正军 1朱绍华 1董旭炀 1韩者艺 1时永全 1周新民 1韩英1
作者信息
- 1. 第四军医大学西京消化病医院肝病科,陕西西安710032
- 折叠
摘要
Abstract
Objective To observe the clinical feature and curative efficacy of AIH - PBC overlap syndrome. Methods Study 1: Clinical features of 124 patients with primary biliary cirrhosis, 57 patients with autoimmune hepatitis and 39 patients with AIH - PBC overlap syndrome were retrospectively analyzed. Study 2: Curative efficacy of 39 patients with AIH - PBC overlap syndrome were grouping analyzed based on different treatment schedule. Results AIH - PBC overlap syndrome constituted 17.73% of 220 patients with autoimmune liver diseases. No significant differences were found in sex ratio and symptoms of fatigue and jaundice among three groups. But there were significance in age and symptom of pruritus among them(P<0.05). The levels of ALT, AST, ALP and GGT had significant differences. ANA, AMA, Gp210 and SPIOO were found in AIH -PBC overlap group and the positive rates of AMA, Gp210 and SP100 were remarkably higher than AIH group whereas the rate of SMA was higher than PBC group( P <0.05). The pathological findings in the overlap syndrome showed combined features of AIH and PBC. Whatever UDCA added or not added in glucocorticoids, level of ALP and GGT decreased after therapy. In combined group, the improvement of ALT, AST, GLB and IgG got significance(P<0. 05). Biochemical responses in terms of AIH fea-tures( ALT decline to normal, IgG≤ 16 g/L) were achieved in especially combined group. Although more alleviation of inflammatory infiltration and damage of bile ducts appeared in combined group, adverse reaction such as fracture or alimentary tract hemorrhage were also higher observed in this group. Conclusion AIH - PBC overlap syndrome showed combined features of both PBC and AIH and there were unique characteristic of its own. Combination of UDCA and glucocorticoids is benefit for achieving better biochemical response and pathological improvement for AIH - PBC overlap syndrome.关键词
肝炎,自身免疫性/肝硬化,胆汁性/治疗效果Key words
hepatitis, autoimmune/liver cirrhosis, biliary/treatment outcome.分类
医药卫生引用本文复制引用
楚金东,朱疆依,高正军,朱绍华,董旭炀,韩者艺,时永全,周新民,韩英..自身免疫性肝炎和原发性胆汁性肝硬化重叠综合征的临床特征及疗效观察[J].临床肝胆病杂志,2012,28(5):343-348,6.
